Electronic letters to:

Research:
Sylvia H. Ley, Stewart B. Harris, Mary Mamakeesick, Tina Noon, Edith Fiddler, Joel Gittelsohn, Thomas M.S. Wolever, Philip W. Connelly, Robert A. Hegele, Bernard Zinman, and Anthony J.G. Hanley
Metabolic syndrome and its components as predictors of incident type 2 diabetes mellitus in an Aboriginal community
CMAJ 2009; 180: 617-624 [Abstract] [Full text] [PDF]
*eLetters: Submit a response to this article

Electronic letters published:

[Read eLetter] Results of OGTT in Patients with Metabolic Syndrome non Diabetics
Huseyin Cat   (30 March 2009)

Results of OGTT in Patients with Metabolic Syndrome non Diabetics 30 March 2009
Top
Huseyin Cat
fax: 212-2463713

Send letter to journal:
Re: Results of OGTT in Patients with Metabolic Syndrome non Diabetics

hcatsislietfal{at}gmail.com Huseyin Cat

In this letter we would like to share our experiences about the relationship between the metabolic syndrome (MetS) and oral glucose tolerance test (OGTT). TheMetS was first described in 1998 by Reaven as ‘’syndrome X’’ and termed a multi – metabolic syndrome or insulin resistance, it represented a known risk factor in the development of cardiovascular disease events and was associated with accelerated atherosclerosis (1). The prospective studies show that the MetS, regardless of how it is defined, is a significant predictor of incident diabetes in many different populations, including Native Americans, U.S Hispanics, Mexicans, Turks, Chinese, and Europeans (2-). Since major organization released definition of the metabolic syndrome, it has received a great deal of attention in the scientific literature. Because of the controversy that has enveloped the concept of the MetS, a thorough understanding of the association between the MS and DM. Prediabetes, identified by impaired fasting glucose and/or impaired glucose tolerance (IGT), may predict future development of diabetes mellitus (DM). However, it is not clear whether MetS and prediabetes represent the same or different clinical entities. It’s clinical value for diabetes prediction remains uncertain (3). Same data demonstrate that MS and prediabetes have an overlapping pattern (4). The pathophysiology seems to be largely attributable to insulin resistance with excessive flux of fatty acids implicated. A proinflammatory state probably contributes to the syndrome. In line with this information, a total of 615 patients attending our hypertension clinical unit were studied retrospectively, between January 2007 December 2008. All patients were non diabetic, having MetS (diagnosed according to the IDF definition (5) and have been tested with 75 gram glucose. 2-hour Oral glucose tolerance test (OGTT) interpreted according 1999 WHO criteria. Resultats are as follow; 39(6.3%)patients were diabetic, 200(32.5%) had IGT and 376 (61.1%) were normal. Percentage of IGT was higher comparing the prevalence of IGT in Turkey (%6.7) by international standards(6). The metabolic syndrome and its interrelationship with impaired glucose tolerance is unclear. In the AusDiab study while the MS is an effective predictor of incident diabetes, the MS was no better at predicting diabetes than a single blood glucose measurement (7). In particular, it is largely unknown what proportions of participants with impaired glucose tolerance (IGT) have the MS and whether this varies by ethnicity, age, and sex. Because an elevated blood glucose level is a common criterion for all definitions, a close association is to be expected. This association may be even stronger in the subgroup of persons with both IGT and impaired fasting glucose. In conclusion, we agree as Ley and colleagues (8) conclude that MetS may useful for identifying individuals at risk of diabetes. In this retrospective study we observed that pre-diabetes (IGT) and the MetS frequently coexist. In these patients we should systematically practice 2-hour OGTT. 1-Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988;37:1595-607. 2-B-Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM: Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49:403–414, 2007 3-2-Earl S. Ford, MD, MPH, Chaoyang Li, MD, PHD1 and Naveed Sattar, MD, PHD.2Metabolic Syndrome and Incident Diabetes Diabetes Care 2008:31;1898-1904 4-3-Diamantopoulos EJ, Andreadis EA, Tsourous GI, Ifanti GK, Katsanou PM, Georgiopoulos DX, Vassilopoulos CV, Dimitriadis G, Raptis SA. Metabolic syndrome and prediabetes identify overlapping but not identical populations.Exp Clin Endocrinol Diabetes. 2006 Jul;114(7):377-83. 5-Alberti KG, Zimmet P, Shaw J. Metabolic syndrome –a new world-wide definition. A consensus statement from International Diabetes Federation. Diabet Med 2006:23:469-80. 6-Ilhan Satman, Temel Yilmaz, Ahmet Sengül et al. Results of the Turkish Diabetes Epidemiology Study (TURDEP) Population-Based Study of Diabetes and Risk Characteristics in Turkey Diabetes Care 25:1551-1556, 2002 7-C- Cameron AJ, Magliano DJ, Zimmet PZ, Welborn TA, Colagiuri S, Tonkin AM, Shaw JE. The metabolic syndrome as a tool for predicting future diabetes: the AusDiab study. J Intern Med. 2008 Aug;264(2):177-86. Epub 2008 Feb 20. 8-Ley SH, Harris SB, Mamakeesick M, et al. Metabolic syndrome and its components as predictors of incident type 2 diabetes mellitus in an Aboriginal community. CMAJ 2009;180:617-24. Co-Author:Yuksel Altuntas The

Conflict of Interest:

None declared